METABOLIC STUDIES IN PATIENTS WITH INTOLERANCE TO COMPLEX CARBOHYDRATES

Abstract

THE CONCEPT of intolerance is ancient and vague. It arose from the clinical observation that in some persons intestinal symptoms, diarrhea and usually steatorrhea, developed when they were fed complex carbohydrates in amounts that were tolerated by most persons. This concept has been commented on regularly in the literature since at least as early as 18681and was emphasized to American pediatricians by Dr. John Howland in a presidential address before the American Pediatric Society in 1921.2It has not been possible to define this condition exactly, nor is it clear whether celiac disease and intolerance are the same or related conditions. But that it is a real disorder has been readily affirmed by numerous clinicians experienced in dealing with chronic intestinal disorders in infants and children.3The literature contains limited quantitative data concerning the defects in absorption and disturbances in metabolism which accompany carbohydrate